${page.setTitle("旅行就医 | 查询推荐套餐")}
<form action="/packagetest/result">
医院id：<input name="hospitalId" id="hospitalId" value=""/><br/>
就诊日期：<input name="clicStrDate" id="clicStrDate" value=""/><br/>
出发城市：<input name="startCity" id="startCity" value=""/><br/>
出发日期:<input name="startDate" id="startDate" value=""/><br/>
出行人数:<input name="peopleNum" id="peopleNum" value=""/><br/>
交通工具：<select name="vehicle" id="vehicle" onchange="changeVehicle()">
<option value="0" selected>飞机</option>
<option value="1">火车</option>
</select><br/>
预定房间：<input name="orderRoom" id="orderRoom" value=""/><br/>
入住天数：<input name="arrivalDays" id="arrivalDays" value=""/><br/>
陪诊服务：<input type="checkbox" name="medicalServices"/><br/>
<input type="submit" value="确&nbsp;&nbsp;定"/>
</form>
